Keyne C. Law

The Association Between State Laws Regulating Handgun Ownership and Statewide Suicide Rates

OBJECTIVESnWe examined the impact of 3 state laws (permit to purchase a handgun, registration of handguns, license to own a handgun) on suicide rates.nnnMETHODSnWe used 2010 data from publicly available databases and state legislatures to assess the relationships between our predictors and outcomes.nnnRESULTSnResults largely indicated that states with any of these laws in place exhibited lower overall suicide rates and suicide by firearms rates and that a smaller proportion of suicides in such states resulted from firearms. Furthermore, results indicated that laws requiring registration and license had significant indirect effects through the proportion of suicides resulting from firearms. The latter results imply that such laws are associated with fewer suicide attempts overall, a tendency for those who attempt to use less-lethal means, or both. Exploratory longitudinal analyses indicated a decrease in overall suicide rates immediately following implementation of laws requiring a license to own a handgun.nnnCONCLUSIONSnThe results are thus supportive of the potential of handgun legislation to have an impact on suicide rates.

How Many Times and How Many Ways: The Impact of Number of Nonsuicidal Self‐Injury Methods on the Relationship Between Nonsuicidal Self‐Injury Frequency and Suicidal Behavior

Several variables have been proposed as heavily influencing or explaining the association between nonsuicidal self-injury (NSSI) and suicidal behavior. We propose that increased comfort with bodily harm may serve as an incrementally valuable variable to consider. We sought to indirectly test this possibility by examining the moderating role of number of NSSI methods utilized on the relationship between NSSI frequency and lifetime number of suicide attempts, positing that increased variability in methods would be indicative with a greater general comfort with inflicting harm upon ones own body. In both a large sample of emerging adults (n = 1,317) and a subsample with at least one prior suicide attempt (n = 143), results were consistent with our hypothesis. In both samples, the interaction term was significant, with the relationship between NSSI frequency and suicidal behavior increasing in magnitude from low to mean to high levels of NSSI methods. Although frequency of NSSI is robustly associated with suicidal behavior, the magnitude of that relationship increases as an individual engages in a wider variety of NSSI methods. We propose that this may be due to an increased comfort with the general concept of damaging ones own body resulting from a broader selection of methods for self-harm.

Do theories of suicide play well together? Integrating components of the hopelessness and interpersonal psychological theories of suicide.

Given that suicide is a leading cause of death worldwide, there has been considerable research on theories of suicide risk. Despite the volume of such research, each theory is largely investigated in isolation and there has been little attempt to integrate them. Thus, the goal of the present study is to integrate two theories of suicide risk, Alloy and Abramsons hopelessness theory of suicide (HT) and Joiners interpersonal psychological theory of suicide (IPTS), into one mediational model where the effects of the risk associated with the HT variables (i.e., a negative cognitive style) on suicidal ideation are transmitted by the IPTS (i.e., perceived burdensomeness and thwarted belonging) variables. Participants were 245 young adults with elevated levels of depressive symptoms who completed self-report measures of suicide risk at baseline and a measure of suicidal ideation eight weeks later. The results of a mediated model supported our hypothesis. The effects of the HT variables on suicidal ideation were mediated by the IPTS variables. Furthermore, results did not support the reverse model, suggesting specificity of the direction of our hypotheses. These findings imply that there may be merit in attempting to integrate theories of suicide risk rather than studying them in isolation.

Examining the relationship between coping strategies and suicidal desire in a sample of United States military personnel

Suicidal desire in the military has been previously examined through the lens of the Interpersonal-Psychological Theory of Suicide (IPTS). However, no research has examined the impact of specific coping strategies on perceived burdensomeness, thwarted belongingness, and suicidal ideation in a large population of individuals serving in the US military. Furthermore, the factor structure of previously utilized coping clusters did not apply to our sample of military personnel. Therefore, we found a three-factor solution to be tested in this sample. We hypothesized that specific types of coping behavior clusters (Adaptive and Maladaptive) would predict both IPTS constructs and suicidal ideation. Results indicated that Adaptive and Maladaptive coping clusters predicted the IPTS constructs in the hypothesized directions. However, only the Maladaptive cluster predicted suicidal ideation. These findings implicate the need for further research and suicide prevention efforts focusing on coping strategies, specifically those that are maladaptive in nature, in relation to suicidal ideation in military members.

Manifestations of overarousal account for the association between cognitive anxiety sensitivity and suicidal ideation

BACKGROUNDnRecent evidence suggests an association between cognitive anxiety sensitivity and suicidal ideation. Cognitive anxiety sensitivity has also been implicated as a precursor to various forms of overarousal. These manifestations of overarousal (i.e., agitation, insomnia, nightmares, and anger) may account for the association between cognitive anxiety sensitivity and suicidal ideation.nnnMETHODSnIn Study 1, undergraduate students selectively sampled for recent suicidal ideation completed all measures online. In Study 2, clinical outpatients completed all measures prior to their initial intake appointments at a psychology clinic.nnnRESULTSnStudy 1 demonstrated that agitation and insomnia individually and jointly accounted for the association between cognitive anxiety sensitivity and suicidal ideation, controlling for general anxiety and demographic variables. Study 2 replicated and extended these findings, such that, controlling for demographics, general anxiety, and physical and social anxiety sensitivity, agitation and anger each independently and together accounted for the association between cognitive anxiety sensitivity and suicidal ideation, whereas insomnia and nightmares did not.nnnLIMITATIONSnThis study utilized a cross-sectional design and self-report measures in both samples as well as a sample of undergraduate students in Study 1.nnnCONCLUSIONSnTogether, these findings suggest that agitation and anger may explain the previously established relationship between cognitive anxiety sensitivity and suicidal ideation. Targeting cognitive anxiety sensitivity in treatment may in turn reduce these forms of overarousal and thereby suicide risk.

Treating the Capability for Suicide: A Vital and Understudied Frontier in Suicide Prevention

Current efforts at suicide prevention center largely on reducing suicidal desire among individuals hospitalized for suicidality or being treated for related psychopathology. Such efforts have yielded evidence-based treatments, and yet the national suicide rate has continued to climb. We propose that this disconnect is heavily influenced by an unmet need to consider population-level interventions aimed at reducing the capability for suicide. Drawing on lessons learned from other public health phenomena that have seen drastic declines in frequency in recent decades (HIV, lung cancer, motor vehicle accidents), we propose that current suicidality treatment efforts trail current suicidality theories in their lack of focus on the extent to which individuals thinking about suicide are capable of transitioning from ideation to attempt. We summarize extant evidence for specific capability-centered approaches (e.g., means safety) and propose other options for improving our ability to address this largely overlooked variable. We also note that population-level approaches in this regard would represent an important opportunity to decrease risk in individuals who either lack access to evidence-based care or underreport suicidal ideation, as a reduced capability for suicide would theoretically diminish the potency of suicidal desire and, in this sense, lower the odds of a transition from ideation to attempt.

Repetitive negative thinking and suicide: a burgeoning literature with need for further exploration

Extant research has found a significant overlap between various repetitive negative thinking (RNT) patterns, such as rumination and worry, across different affective disorders implicating that the process of repetitive negative thinking is likely trans-diagnostic. Furthermore, RNT patterns at the core of psychiatric disorders associated with suicide (e.g., rumination and worry) have been found to be associated with suicide even after accounting for the disorder. A synthesis of existing literature on repetitive negative thoughts suggest that following negative emotional experiences, RNTs may lead to a sense of entrapment and hopelessness that may contribute to the onset of suicidal ideation and then facilitate the transition from thinking about suicide to making a suicide attempt by increasing an individuals capability for suicide through repetitive exposure to violent thoughts and imagery associated with suicide.

Dangerous Words? An Experimental Investigation of the Impact of Detailed Reporting About Suicide on Subsequent Risk

OBJECTIVEnMedia reporting guidelines exist for suicide-related content; however, no experimental studies have examined the impact of guideline violations. As such, we utilized an experimental design to determine whether reading an article about suicide that violated guidelines would impact mood and suicidality relative to the same article without violations and to an article detailing death by cancer, both immediately and during 1-month follow-up.nnnMETHODn273 students were randomly assigned to read one of three articles (1) an article that violated suicide reporting guidelines, (2) the same article with violations removed, or (3) an article that details death by cancer.nnnRESULTSnIndividuals assigned to read the original suicide article were no more upset immediately afterwards or during 1-month follow-up. Amongst participants with prior ideation, those who read the original article reported a lower likelihood of future attempt relative to either other condition.nnnCONCLUSIONnResults indicate some reporting guidelines may be unnecessary. Amongst individuals at risk for suicide, some guideline violations may be associated with a decreased likelihood of future attempt and result in a decrease in negative affect. Clinically, these results highlight the potential utility of exposing clients to in depth educational materials about suicide while mitigating concerns regarding certain aspects of the content.

Overarousal as a mechanism of the relation between rumination and suicidality

Rumination, particularly brooding, is associated with suicidal ideation and attempts; however, mechanisms of these associations have not been identified. The present study examined manifestations of overarousal-agitation, insomnia, and nightmares-that have been linked to both rumination and suicide as indirect indicators of the link between brooding and suicidal ideation/attempts. A sample of 492 psychiatric outpatients (64.2% female), aged 17-65 years (Mxa0=xa026.75, SDxa0=xa010.32), completed self-report measures before their intake appointments with a therapist. Results indicated that agitation and nightmares, but not insomnia, each significantly explained the association between brooding and suicidal ideation and between brooding and the presence of a past suicide attempt. Overall, these findings provide evidence that certain types of overarousal may serve as a mechanism of the association between brooding and suicidal ideation and attempts. Clinical implications, limitations, and future research directions are discussed.

The intensity of suicidal ideation at the worst point and its association with suicide attempts

This study seeks to determine if the severity of suicidal ideation at the worst point can differentiate individuals who think about suicide (ideators) from those who make a suicide attempt (attempters). Subsequently, the indirect effect of worst point ideation on differentiating ideators from attempters through various pathways such as an increased capability for suicide, painful and provocative experiences, non-suicidal self-injury (NSSI), and planning for suicide was examined. The sample included 229 adults with a lifetime history of suicidal ideation who were recruited through Amazons Mechanical Turk program and asked to complete a battery of self-report questionnaires. Furthermore, the sample was oversampled on the basis of prior suicide attempts. Our results suggest that there is a strong relationship between worst point ideation and suicide attempts such that there is a greater likelihood of endorsing past suicide attempts when individuals reported high intensity at the worst point of their suicidal ideation. An elevated level of painful and provocative events partially accounted for the aforementioned relationship while a heightened capability for suicide. The results from the present study suggest utility in managing intensity of suicidal ideation and the importance of addressing painful and provocative behaviors to prevent potentially lethal suicide attempts in the future.